Learning from each other to improve care Sharing digital blueprints across the NHS

Learning from each other to improve care - Sharing digital blueprints across the NHS

How can the sharing of Global Digital Exemplar (GDE) blueprints help improve outcomes for patients and staff? Here Paul Charnley, Director of IT and Information at Wirral University Teaching Hospital NHS Foundation Trust and CIO co-chair of the Blueprinting Steering Group for the Global Digital Exemplar programme, gives his thoughts on the launch of the first round of 60 blueprints and how he’s learning from them too.

By Paul Charnley. 9 April 2019

Picture with four clinical staff walking down the aisle of ward 30 to discuss a patient treatment, Wirral University Teaching Hospital

Sharing and learning from what we do well is at the heart of NHS England’s Global Digital Exemplars blueprints.

Created by NHS Trusts already recognised for using digital technologies to support wider change, the GDE blueprints are step by step guides that can be tailored by health systems and providers to suit their own local needs and requirements.

I have been involved in the blueprinting project over the past 18 months and I’ve been happy to bring my 40 years’ experience to help shape this national approach to sharing and learning from each other.

Throughout that journey we have seen what works and sometimes what doesn’t, but it’s important we share those lessons with others.

For example, in my trust, in the Wirral, we introduced electronic prescribing and medicines administration in the 1990s and since then hospital patients have been safer because the system is able to check for any errors.

At the time of launch we hosted visits to view the system and documented how we achieved what we did. Just as importantly, we told people about what we got wrong because we went live with the technology and then had to stop and try again. This was because the system we adopted was from the USA and dealt with administering drugs in a different way (e.g. the quantities related to a quarter of a tablet instead of 0.5mg) so we had to a re-write it to anglicise the process.

There is even a very old VHS tape, with some of us looking really young, saying things that are still relevant today: “we should involve clinicians”, “we need to consider safety first”, “training and early support is critical.”

Working on the GDE blueprints has been a welcome learning experience for me because of the insight I’ve gained from how people have used them as a channel to share what they have been doing well.

For example, we in the Wirral have used the blueprint from Cambridge University Hospitals showing how they have adapted their EPIC system to introduce closed loop medicines administration – technology for checking the right dose of medication - and the management of breast milk for babies. These are things we had not tackled – but the Cambridge blueprint gave us the confidence to do so.

We also learned a lot from University Hospitals Birmingham as they are ahead of us in the development and use of patient portals. There are also some brilliant examples of how trusts are adopting standards such as transfers of care in Newcastle upon Tyne Hospitals, mobile apps for young mental health patients to use in Worcestershire Health and Care and voice to text solutions in Oxford Health.

The blueprints describe some common themes about leadership, governance, ownership and engagement, and we need to distil and sprinkle this learning more widely around the NHS. That’s the beauty of the blueprints, all of which demonstrate the benefits to patient care by applying technology where it’s appropriate.

Those benefits include:

Creating new partnerships with patients and their families, paving the way for them to be more fully involved in their care

Saving time previously spent doing administration

Ensuring the systems can protect against errors

Providing early warning of problems ahead

I am looking forward to welcoming the next wave of blueprints and being part of the process to help speed up the pace of change at scale across the NHS, as we become more confident that all this can happen - because it is already being done elsewhere.

So, whether you want to share records electronically, make prescribing safer (more legible, with inbuilt error checking and guided by rules), record observations electronically (saving time, making them more accurate and directly feeding in to warnings) or develop a patient portal, there is a lot to learn from visiting the new GDE Community Platform (FutureNHS) where all the blueprints are showcased, regardless of whether you come from acute care or mental health.

In my case this is all proof that you CAN teach an old dog new tricks...

These and other GDE blueprints are now available on the GDE Community Platform. Please email gdeblueprints@nhsx.nhs.uk